Healthcare Provider Details

I. General information

NPI: 1487865267
Provider Name (Legal Business Name): TTHOMAS CHARLES LEHMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 HIGHWAY 30 E
CARROLL IA
51401
US

IV. Provider business mailing address

529 TROY DR PO 93
CARROLL IA
51401-1721
US

V. Phone/Fax

Practice location:
  • Phone: 712-775-6337
  • Fax:
Mailing address:
  • Phone: 712-792-1131
  • Fax: 712-792-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number13047
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: